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Proposed Rule

Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2008 Rates; Correction

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Information about this document as published in the Federal Register.

Published Document

This document has been published in the Federal Register. Use the PDF linked in the document sidebar for the official electronic format.

Start Preamble

AGENCY:

Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION:

Correction of proposed rule.

SUMMARY:

This document corrects technical errors that appeared in the proposed rule entitled “Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2008 Rates” that appeared in the May 3, 2007 Federal Register.

Start Further Info

FOR FURTHER INFORMATION CONTACT:

Marc Hartstein, (410) 786-4548.

End Further Info End Preamble Start Supplemental Information

SUPPLEMENTARY INFORMATION:

I. Background

In FR Doc. 07-1920 of May 3, 2007 (72 FR 24680), there were a number of technical errors that are identified and corrected in the Correction of Errors section of this notice. We issued the fiscal year (FY) 2008 hospital inpatient prospective payment systems (IPPS) proposed rule on April 13, 2007. The FY 2008 IPPS proposed rule appeared in the May 3, 2007 Federal Register.

II. Summary of Errors

We recently discovered that an error was made in the calculation of the DRG relative weights presented in the FY 2008 IPPS proposed rule. We have revised the relative weights to correct the error and have recalculated the standardized amounts. These changes increase the standardized amounts slightly and reduce the proposed FY 2008 outlier threshold by $85. Further, these revisions affect the DRG-specific costs thresholds for new technology add-on payments. Therefore, in this notice we are correcting the following:

  • Preamble language regarding the methodology used to calculate charge-based and cost-based relative weights.
  • Outlier threshold.
  • Recalibration, wage and recalibration, geographic reclassification, and rural floor budget neutrality factors.
  • Tables 1A through 1D, 2, 4A, 4C, 4J, 5, 10.
  • Impact analysis tables (Tables I and II).

In addition, we have posted these corrected tables on our Web site at http://www.cms.hhs.gov/​AcuteInpatientPPS/​WIFN/​list.asp.

III. Correction of Errors

In FR Doc. 07-1920 of May 3, 2007 (72 FR 24680), make the following corrections:

A. Corrections to the Preamble

1. On page 24711, second column, last paragraph, sixth line from the bottom, the figure “$23,015” is corrected to read “$22,930.”

2. On page 24746, second column,

a. Third full paragraph, line 9, the phrase, “in the FY 2005 MedPAR” is corrected to read “in the FY 2006 MedPAR.”

b. Fifth full paragraph, last line, after the phrase “cost of living adjustment.”, the following sentence is added to read as follows:

“Beginning with FY 2008, because hospital charges include charges for both operating and capital costs, we are proposing to standardize total charges to remove the effects of differences in geographic adjustment factors, large urban add-on payments, cost-of-living adjustment, disproportionate share payments, and IME adjustments under the capital IPPS as well.”

3. On page 24747, first column, third full paragraph, last line, after the phrase “cost of living adjustment.” and before the phrase “Charges were then”, the following sentence is added to read as follows:

“Beginning with FY 2008, because hospital charges include charges for both operating and capital costs, we are proposing to standardize total charges to remove the effects of differences in geographic adjustment factors, large urban add-on payments, cost-of-living adjustment, disproportionate share payments, and IME adjustments under the capital IPPS as well.”

B. Corrections to the Addendum

1. On page 24836,

a. First column, second full paragraph,

(1) Line 14, the figure “0.999317” is corrected to read “0.999367.”

(2) Lines 19 and 29, the figure “0.998557” is corrected to read “0.998573.”

b. Second column, first partial paragraph, line 17, the figure “0.991938” is corrected to read “0.991925.”

2. On page 24837, second column, second full paragraph, line 6, the figure “$23,015” is corrected to read “$22,930”.

3. On page 24839, top half of the page, in the table Comparison of FY 2007 Standardized Amounts to Proposed FY 2008 Single Standardized Amount with Full Update and Reduced Update, the figures in the listed entries are corrected to read as follows:

Full update (3.3 percent)Reduced update (1.3 percent)
FY 2008 DRG Recalibrations and Wage Index Budget Neutrality Factor0.9993670.999367
FY 2008 Reclassification Budget Neutrality Factor0.9919250.991925
Start Printed Page 31508

4. On page 24846, third column, first full paragraph,

a. Line 38, the figure “$417.26” is corrected to read “$417.12.”

b. Line 40, the figure “$413.87” is corrected to read “$413.73.”

5. On page 24847,

a. Middle of the page, in the table Comparison of Factors and Adjustments: FY 2007 Capital Federal Rate and Proposed FY 2008 Capital Federal Rate for Urban Hospitals, third column, last row, the figure, “$413.87” is corrected to read “$413.73.”

b. Lower third of the page, in the table Comparison of Factors and Adjustments: FY 2007 Capital Federal Rate and Proposed FY 2008 Capital Federal Rate for Rural Hospitals, third column, last row, the figure “$417.26” is corrected to read “$417.12.”

6. On page 24848,

a. First column, fourth full paragraph,

(1) Line 10, the phrase “is $197.21” is corrected to read “is $197.11.”.

(2) Line 12, the figure “$195.60” is corrected to read “$195.51.”

b. Second column, third paragraph, last line, the figure “$23,015” is corrected to read “$22,930”.

7. On page 24850, in Table 1A.—National Adjusted Operating Standardized Amounts, Labor/Nonlabor (69.7 Percent Labor Share/30.3 Percent Nonlabor Share If Wage Index Greater Than 1), the table is corrected to read as follows:

Table 1A.—National Adjusted Operating Standardized Amounts, Labor/Nonlabor (69.7 Percent Labor Share/30.3 Percent Nonlabor Share If Wage Index Greater Than 1)

Full update (3.3 percent)Reduced update (1.3 Percent)
Labor-relatedNonlabor-relatedLabor-relatedNonlabor-related
$3,430.41$1,491.27$3,363.99$1,462.40

8. On page 24850, in Table 1B.—National Adjusted Operating Standardized Amounts, Labor/Nonlabor (62 Percent Labor Share/38 Percent Nonlabor Share If Wage Index Less Than Or Equal To 1), the table is corrected to read as follows:

Table 1B.—National Adjusted Operating Standardized Amounts, Labor/Nonlabor (62 Percent Labor Share/38 Percent Nonlabor Share If Wage Index Less Than or Equal to 1)

Full update (3.3 percent)Reduced update (1.3 Percent)
Labor-relatedNonlabor-relatedLabor-relatedNonlabor-related
$3,051.44$1,870.24$2,992.36$1,834.03

9. On page 24850, in Table 1C.—Adjusted Operating Standardized Amounts For Puerto Rico Labor, Labor/Nonlabor, the table is corrected to read as follows:

Table 1C.—Adjusted Operating Standardized Amounts for Puerto Rico, Labor/Nonlabor

Rates if wage index greater than 1Rates if wage index less than or equal to 1
LaborNonlaborLaborNonlabor
National$3,430.41$1,491.27$3,363.99$1,462.40
Puerto Rico1,442.16883.901,365.40960.66

10. On page 24850, in Table 1D.—Capital Standard Federal Payment Rate, the table is corrected to read as follows:

Table 1D.—Capital Standard Federal Payment Rate

Urban rateRural rate
National$413.73$417.12
Puerto Rico195.51197.11

11. On pages 24851 through 24917, in Table 2.—Hospital Case-Mix Indexes For Discharges Occurring in Federal Fiscal Year 2006; Hospital Wage Indexes For Federal Fiscal Year 2008; Hospital Average Hourly Wages For Federal Fiscal Years 2006 (2002 Wage Data), 2007 (2003 Wage Data), And 2008 (2004 Wage Data); And 3-Year Average Of Hospital Average Hourly Wages, the wage index for the listed provider numbers are corrected to read as follows: Start Printed Page 31509

Provider No.FY 2008 wage index
0100120.9390
0100470.7776
0100520.7701
0101090.8049
0101100.7900
0101640.8042
0400140.8720
0400170.8718
0400410.8720
0400710.8720
0400760.8720
0400780.8720
0401000.8720
0401190.8720
0500071.4907
0500081.4792
0500091.4200
0500131.4200
0500161.2015
0500471.4792
0500551.4792
0500701.4907
0501131.4907
0501521.4792
0502281.4792
0502321.2015
0502801.2826
0502891.4907
0504071.4792
0504541.4792
0504571.4792
0505061.2015
0506331.2015
0506671.4200
0506681.4792
0506971.2826
0507071.4907
0507331.2826
0507541.4907
0600100.9730
0600300.9730
0800011.0777
0800031.0777
1001020.8874
1002900.9331
1101070.9752
1101640.9752
1102010.9752
1300660.9680
1300680.9680
1500150.8904
1600301.0022
1800130.9407
1800640.8131
1800660.9407
1800790.8075
1800800.8042
1801240.9407
1900440.7849
1901900.7752
1902460.7752
2000320.8878
2100280.9429
2300360.9398
2300410.9398
2300471.0091
2300800.9398
2301050.9398
2301951.0091
2302041.0091
2302220.9398
2302271.0091
2302571.0091
2302641.0091
2302971.0091
2302991.0091
2303001.0091
2400061.0760
2400101.0760
2400181.0084
2400611.0760
2400691.0760
2400711.0760
2700810.8574
2800650.9746
3100101.0812
3100111.0864
3100141.0777
3100441.0812
3100811.0777
3100921.0812
3101101.0812
3200010.9739
3200050.9739
3200060.9739
3200090.9739
3200110.9407
3200170.9739
3200190.9739
3200210.9739
3200370.9739
3200740.9739
3200790.9739
3200830.9739
3301351.1528
3302051.1528
3302641.1528
3401330.8916
3600440.8825
3701130.8718
3800291.0479
3800511.0479
3800561.0479
3900441.0777
3900961.0777
3901331.0777
4100131.1793
4300120.9394
4300130.9394
4300480.8398
4400110.8042
4400150.8042
4400190.8042
4400300.7972
4400340.8042
4400350.9407
4400560.8042
4400730.9407
4400840.7949
4401100.8042
4401200.8042
4401250.8042
4401440.9407
4401480.9407
4401510.9407
4401530.7923
4401730.8042
4401750.9407
4401920.9407
4402250.8042
4402260.8042
4503700.8444
4505650.8690
4507550.8498

12. On pages 24924, 29426, and 24941, in Table 4A.—Wage Index and Capital Geographic Adjustment Factor (GAF) for Urban Areas by CBSA—FY 2008, the wage index and GAF for the listed CBSAs are corrected to read as follows:

CBSA codeUrban areaWage indexGAF
10740Albuquerque, NM0.97390.9821
Bernalillo County, NM
Sandoval County, NM
Torrance County, NM
Valencia County, NM
13020Bay City MI0.93980.9584
Bay County, MI
40340Rochester, MN1.07601.0514
Dodge County, MN
Olmsted County, MN
Wabasha County, MN

13. On pages 24948 through 24951, in Table 4C.—Wage Index And Capital Geographic Adjustment Factor (GAF) For Hospitals That Are Reclassified By CBSA FY 2008, the wage indices and GAFs for the listed areas are corrected to read as follows:Start Printed Page 31510

CBSA codeAreaWage indexGAF
10740Albuquerque, NM0.97390.9821
13020Bay City, MI0.93980.9584
22220Fayetteville-Springdale-Rogers, AR-MO0.87180.9103
35980Norwich-New London, CT1.17931.1196
40340Rochester, MN1.07601.0514
40660Rome, GA0.93900.9578
43620Sioux Falls, SD0.93940.9581

14. On pages 24952 through 24960, in Table 4J.—Out-Migration Adjustment—FY 2008, the entries for the listed providers are corrected to read as follows:

Provider No.Reclassified for FY 2008Out-migration adjustmentQualifying county nameCounty code
010009*0.0092MORGAN01510
010025*0.0235CHAMBERS01080
0100380.0039CALHOUN01070
0100470.0178BUTLER01060
0100520.0103TALLAPOOSA01610
010054*0.0092MORGAN01510
010065*0.0103TALLAPOOSA01610
0100780.0039CALHOUN01070
010085*0.0092MORGAN01510
0101090.0451PICKENS01530
0101100.0302BULLOCK01050
0101460.0039CALHOUN01070
010150*0.0178BUTLER01060
0500070.0141SAN MATEO05510
0500080.0026SAN FRANCISCO05480
0500160.0103SAN LUIS OBISPO05500
0500470.0026SAN FRANCISCO05480
0500550.0026SAN FRANCISCO05480
0500700.0141SAN MATEO05510
050076*0.0026SAN FRANCISCO05480
0501130.0141SAN MATEO05510
0501520.0026SAN FRANCISCO05480
050194*0.0052SANTA CRUZ05540
050197*0.0141SAN MATEO05510
0502280.0026SAN FRANCISCO05480
0502320.0103SAN LUIS OBISPO05500
050242*0.0052SANTA CRUZ05540
0502890.0141SAN MATEO05510
0504070.0026SAN FRANCISCO05480
0504540.0026SAN FRANCISCO05480
0504570.0026SAN FRANCISCO05480
0505060.0103SAN LUIS OBISPO05500
050541*0.0141SAN MATEO05510
0506330.0103SAN LUIS OBISPO05500
0506680.0026SAN FRANCISCO05480
0507070.0141SAN MATEO05510
050714*0.0052SANTA CRUZ05540
0507540.0141SAN MATEO05510
0600100.0153LARIMER06340
0600300.0153LARIMER06340
080001*0.0063NEW CASTLE08010
080003*0.0063NEW CASTLE08010
1001020.0125COLUMBIA10110
100156*0.0125COLUMBIA10110
1002900.0582SUMTER10590
110146*0.0805CAMDEN11170
130049*0.032KOOTENAI13270
1300660.032KOOTENAI13270
130067*0.0696BINGHAM13050
1300680.032KOOTENAI13270
140167*0.1055IROQUOIS14460
150006*0.0113LA PORTE15450
1500150.0113LA PORTE15450
150146*0.0319NOBLE15560
1600300.004STORY16840
170137*0.0336DOUGLAS17220
Start Printed Page 31511
1800640.0319MONTGOMERY18860
180066*0.0449LOGAN18700
1800790.0263HARRISON18480
1900440.0258ACADIA19000
190099*0.0188AVOYELLES19040
190184*0.0161CALDWELL19100
1901900.0161CALDWELL19100
1902460.0161CALDWELL19100
2000320.0466OXFORD20080
2100280.0512ST. MARY'S21180
230069*0.0209LIVINGSTON23460
230279*0.0209LIVINGSTON23460
2400180.0872GOODHUE24240
2700810.0237MUSSELSHELL27320
300011*0.0069HILLSBOROUGH30050
300012*0.0069HILLSBOROUGH30050
300020*0.0069HILLSBOROUGH30050
300034*0.0069HILLSBOROUGH30050
3100100.0092MERCER31260
3100110.0115CAPE MAY31180
310021*0.0092MERCER31260
3100440.0092MERCER31260
3100920.0092MERCER31260
3101100.0092MERCER31260
320003*0.0629SAN MIGUEL32230
3200110.0442RIO ARRIBA32190
330027*0.0149NASSAU33400
330106*0.0149NASSAU33400
330167*0.0149NASSAU33400
330181*0.0149NASSAU33400
330182*0.0149NASSAU33400
330198*0.0149NASSAU33400
330225*0.0149NASSAU33400
330259*0.0149NASSAU33400
330331*0.0149NASSAU33400
330332*0.0149NASSAU33400
330372*0.0149NASSAU33400
3401330.0308MARTIN34580
360010*0.0076TUSCARAWAS36800
360013*0.0136SHELBY36760
360025*0.0072ERIE36220
3600440.0124DARKE36190
360096*0.0072COLUMBIANA36140
360175*0.0176CLINTON36130
360185*0.0072COLUMBIANA36140
380022*0.0068LINN38210
3800290.0075MARION38230
3800510.0075MARION38230
3800560.0075MARION38230
390030*0.0284SCHUYLKILL39650
390031*0.0284SCHUYLKILL39650
390065*0.049ADAMS39000
390138*0.0213FRANKLIN39350
390151*0.0213FRANKLIN39350
390162*0.02NORTHAMPTON39590
390181*0.0284SCHUYLKILL39650
390183*0.0284SCHUYLKILL39650
390313*0.0284SCHUYLKILL39650
420009*0.0113OCONEE42360
420039*0.0153UNION42430
420062*0.0109CHESTERFIELD42120
4400300.0056HAMBLEN44310
440067*0.0056HAMBLEN44310
4400840.0033MONROE44610
4401530.0007COCKE44140
450324*0.0132GRAYSON45564
4503700.024COLORADO45312
450393*0.0132GRAYSON45564
450395*0.0451POLK45850
450438*0.024COLORADO45312
450469*0.0132GRAYSON45564
4505650.0486PALO PINTO45841
4507550.0294HOCKLEY45652
Start Printed Page 31512
510077*0.0021MINGO51290

15. On pages 24960 through 24977, in Table 5.—List of Proposed Medicare Severity-Diagnosis Related Groups (MS-DRGs), Relative Weighting Factors, and Geometric and Arithmetic Mean Length of Stay, the table is corrected to read as follows:

Start Printed Page 31513

Start Printed Page 31514

Start Printed Page 31515

Start Printed Page 31516

Start Printed Page 31517

Start Printed Page 31518

Start Printed Page 31519

Start Printed Page 31520

Start Printed Page 31521

Start Printed Page 31522

Start Printed Page 31523

Start Printed Page 31524

Start Printed Page 31525

Start Printed Page 31526

Start Printed Page 31527

Start Printed Page 31528

Start Printed Page 31529

Start Printed Page 31530

Start Printed Page 31531

16. On pages 25095 through 25099, in Table 10.—Geometric Mean Plus The Lesser of .75 Of The National Adjusted Operating Standardized Payment Start Printed Page 31532Amount (Increased To Reflect The Difference Between Costs And Charges) Or .75 Of One Standard Deviation Of Mean Charges By Proposed Medicare Severity Diagnosis Related Group (MS-DRG) April 2007,[1] the table is corrected to read as follows:

Proposed MS-DRGNumber of casesThreshold
1629$337,776
2328177,459
323,999266,199
421,742162,448
5842159,506
649590,877
7413130,276
856092,482
91,35896,148
1017772,498
111,28971,569
121,92351,377
131,48436,890
20901138,451
21558107,625
2225174,547
233,11281,762
242,57660,740
258,41779,522
2611,62652,970
2714,45441,141
281,60973,994
292,86245,280
303,75130,578
311,05759,862
322,98735,341
334,26330,562
3481358,045
352,50642,020
367,71036,365
374,77751,688
3814,60233,107
3955,35725,687
404,54958,682
417,72039,547
425,43034,186
521,15629,433
5359322,836
544,66430,610
5516,89624,934
567,71629,072
5748,43219,657
5878928,525
592,63922,939
604,20117,679
611,34053,318
622,28841,979
631,18536,186
6455,55234,358
65112,18927,004
6694,54721,586
671,38330,616
6812,39323,506
69103,74718,936
707,09234,031
7110,00126,444
726,05620,628
738,65526,844
7432,52321,427
751,19733,931
7687424,318
771,10132,854
781,30724,933
7995720,523
802,07724,135
818,19017,502
821,64633,910
831,94028,383
842,59122,654
855,32835,679
8610,38226,404
8712,15220,144
8871730,107
892,64123,706
903,31917,874
916,67629,690
9214,89022,313
9315,48417,172
941,52156,938
951,08842,964
9675536,338
971,25251,314
981,04835,977
9964230,167
10015,83728,714
10156,90519,341
1021,35224,321
10315,02317,133
11356831,544
11460121,640
1151,09825,563
11666523,828
1171,40016,827
12158722,514
12267413,518
1232,84319,108
12467924,153
1254,70516,568
1291,37437,663
1301,07228,539
13165535,824
13272827,050
1331,35231,142
1342,66120,306
13578135,301
1361,11324,451
1371,10828,410
1381,37020,587
1392,14522,300
14668735,060
1471,42225,142
14893518,944
14939,24815,883
15093925,105
1516,80113,607
1522,35222,958
15316,02815,145
1541,84327,851
1554,20722,020
1565,14016,103
1571,14528,232
1583,03921,662
1592,41815,345
16313,43179,829
16418,04747,971
16514,55337,942
16620,29058,779
16720,77240,117
1685,75830,294
17511,95433,475
17640,17326,670
17757,17936,617
17871,19230,381
17927,45424,673
18022,47432,948
18132,15626,822
1826,16322,468
1831,65429,694
1844,14122,561
1852,59315,740
1868,53331,857
1879,96825,761
1885,14820,974
189104,53128,757
19057,04127,770
191121,65924,280
192196,90318,419
19388,05329,668
194266,59924,679
195147,74418,274
1965,14330,999
1976,89425,721
1984,94321,129
1993,25733,231
2008,18523,984
2013,52317,676
20231,58720,635
20341,58715,003
20426,03917,394
2055,77526,368
20622,41518,854
20746,16583,212
20879,43241,398
215150151,502
2168,411165,422
2177,609118,088
2183,25698,470
21910,062132,460
22013,48194,478
2218,38381,144
2222,865149,784
2235,770116,219
2241,919138,213
2255,871109,030
2267,048112,464
22750,53688,444
2283,084126,976
2294,12889,139
2301,98973,311
2311,478138,287
2321,795107,403
23316,911119,988
23439,16786,734
2359,62897,022
23632,87168,172
23721,78985,211
23844,92953,794
23913,81464,168
24013,34943,051
2413,35031,297
24217,17964,273
24337,85650,218
24468,20142,102
2456,24154,054
24632,66164,613
247279,97246,787
2485,01358,218
24929,65741,876
2505,73953,408
25139,90538,200
25244,60248,168
25346,86443,475
25459,02934,550
2552,60939,961
2563,83330,250
25777423,818
25859849,682
Start Printed Page 31533
2597,32835,034
26086747,446
2612,80428,303
2623,37823,301
26378829,053
26430,13739,708
28060,73536,717
28157,73428,584
28260,95123,031
28315,85230,928
2844,91123,409
2853,25417,351
28623,28240,266
287172,48828,923
2883,24550,617
2891,42336,464
29048428,249
291183,77429,157
292217,05224,421
293226,68817,810
2941,70421,989
2951,65813,805
2961,73026,654
29794320,306
29855412,889
29917,44328,063
30046,82021,997
30139,91015,712
3027,87323,741
30381,45815,192
3042,08424,110
30535,64615,139
3061,37927,644
3076,44718,857
30833,52827,255
30979,75120,827
310160,73814,816
31124,86713,364
312169,24718,273
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5474,88018,469
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84723,66725,136
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95981653,566
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9641,57832,525
9652,01627,560
96959875,122
97023147,821
9747,27634,615
9753,46329,344
9762,72823,762
9774,87123,005
98126,28077,452
98218,59453,442
9836,76638,481
98466955,818
9851,04838,813
98689027,837
9878,03654,475
98811,88036,064
9896,53726,243
9991816,006

17. On pages 25118 through 25123, in Table I.—Impact Analysis of Proposed Changes For FY 2008, the listed entries and footnotes are corrected to read as follows:

Start Printed Page 31536

Start Printed Page 31537

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18. On page 25124,

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a. First column, second full paragraph, line 25, the figure “0.999317” is corrected to read “0.999367.”

b. Second column, last paragraph, line 3, the figure “0.999317” is corrected to read “0.999367.”

19. On page 25125,

a. First column, last paragraph, line 5, the figure “0.991938” is corrected to read “0.991925.”

b. Second column, first full paragraph, line 17, the figure “0.997084” is corrected to read “0.997080.”

20. On pages 25126 through 25128, in Table II.—Impact Analysis of Proposed Changes For FY 2008 Operating Prospective Payment System, the listed entries are corrected to read as follows:

Table II.—Impact Analysis of Proposed Changes for FY 2008 Operating Prospective Payment System (Payments per Case)

[Percent changes in payments per case]

Number of hospitalsPublished average proposed FY 2008 payment per case 1Corrected average proposed FY 2008 payment per case 1Published all proposed FY 2008 changesCorrected all proposed FY 2008 changes
(1)(3)(3)(4)(4)
All hospitals3535929992993.33.3
By Geographic Location:
Urban hospitals2540967896803.63.6
Large urban areas (populations over 1 million)140910156101574.24.2
Other urban areas (populations of 1 million or fewer)1131910391072.82.9
Rural hospitals995712371100.90.7
Bed Size (Urban):
0-99 beds632726372610.40.3
100-199 beds849817081593.43.2
200-299 beds480912091173.53.4
300-499 beds41210136101434.04.0
500 or more beds16712234122544.04.2
Bed Size (Rural):
0-49 beds34260656045−1.6−1.9
50-99 beds369658865720.50.2
100-149 beds172696069451.31.1
150-199 beds67773577271.41.3
200 or more beds45893889372.02.0
Urban by Region:
New England12610001100042.62.6
Middle Atlantic35010529105322.82.8
South Atlantic388917591764.24.3
East North Central395919791993.43.5
East South Central166878487863.23.2
West North Central156932193342.83.0
West South Central358917491754.04.0
Mountain153982698363.33.5
Pacific39511657116564.74.7
Puerto Rico53452545113.63.3
Rural by Region:
New England19971497160.40.4
Middle Atlantic72752575140.80.6
South Atlantic173670066831.81.6
East North Central124757475670.70.6
East South Central177647964621.21.0
West North Central115779277860.60.6
West South Central19463396322−0.7−0.9
Mountain80783478220.90.7
Pacific41889688812.01.8
By Payment Classification:
Urban hospitals2619962996313.63.6
Large urban areas (populations over 1 million)143610127101284.14.1
Other urban areas (populations of 1 million or fewer)1183903490382.82.8
Rural areas916724272300.90.8
Teaching Status:
Non-teaching2479785178442.72.6
Fewer than 100 Residents816938493853.53.5
100 or more Residents24013533135554.14.2
Urban DSH:
Non-DSH879830783142.02.1
100 or more beds152710182101834.04.0
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Less than 100 beds359669766821.91.6
Rural DSH:
SCH391701369940.30.0
RRC189781878091.71.6
100 or more beds36602860102.11.8
Less than 100 beds154535353350.40.0
Urban teaching and DSH:
Both teaching and DSH80511185111924.04.1
Teaching and no DSH192907890892.52.6
No teaching and DSH1081828382733.73.5
No teaching and no DSH541781278171.92.0
Rural Hospital Types:
RRC59835883592.52.5
SCH45930192960.80.8
MDH21633963190.30.0
SCH and RRC1710239102362.72.7
MDH and RRC196749677−0.8−0.8
Type of Ownership:
Voluntary2069942494273.23.2
Proprietary823847884713.73.6
Government598959395893.53.4
Medicare Utilization as a Percent of Inpatient Days:
0-2523013443134345.65.5
25-50129210570105764.04.1
50-651453811681132.62.5
Over 65441733173251.21.2
Hospitals Reclassified by the Medicare Geographic Classification Review Board: FY 2008 Reclassifications:
All Reclassified Hospitals FY 2008801893889372.82.8
All Non-Reclassified Hospitals FY 20082734941794163.43.4
Urban Reclassified Hospitals FY 2008434958195953.33.4
Urban Non-reclassified Hospitals FY 20082105970197053.63.7
Rural Reclassified Hospitals FY 2008367766976631.51.4
Rural Nonreclassified Hospitals FY 200856863926374−0.3−0.6
All Section 401 Reclassified Hospitals31879987871.81.6
Other Reclassified Hospitals (Section 1886(d)(8)(B))61672967101.41.1
Former Section 508 Hospitals107981498230.50.6
Specialty Hospitals
Cardiac Specialty Hospitals221067610727−0.6−0.1
1 These payment amounts per case do not reflect any estimates of annual case-mix increase.
Start Signature

(Catalog of Federal Domestic Assistance Program No. 93.773, Medicare—Hospital Insurance; and Program No. 93.774, Medicare—Supplementary Medical Insurance Program)

Dated: June 1, 2007.

Ann C. Agnew,

Executive Secretary to the Department.

End Signature End Supplemental Information

Footnotes

1.  Cases taken from the FY 2006 MedPAR file; proposed MS-DRGs are from GROUPER Version 25.0.

Back to Citation

6.  Shown here are the tentative effects of geographic reclassifications by the Medicare Geographic Classification Review Board (MGCRB). The effects demonstrate the FY 2008 payment impact of going from no reclassifications to the reclassifications scheduled to be in effect for FY 2008. Reclassification for prior years has no bearing on the payment impacts shown here. This column reflect the geographic budget neutrality factor of 0.991925.

7.  This column displays the effects of the proposed changes in the rural floor budget neutrality adjustment applied on the wage index instead of on the standardized amount. The column reflects a proposed rural floor budget neutrality factor of 0.997080.

11.  This column shows tentative changes in payments from FY 2007 to FY 2008 including a 0.976 case mix index adjustment for coding and documentation improvements that are anticipated with the adoption of the MS-DRGs prior to the assumed growth occurring. In incorporates all of the changes displayed in Columns 4, 5, 6, 7, 8, 9, 10 and (the changes displayed in Columns 2 and 3 are included in Column 4).

12.  This column shows tentative changes in payments from FY 2007 to FY 2008 with a case mix index adjustment and the assumed growth for improvements in documentation and coding. It incorporates all of the changes displayed in Columns 4, 5, 6, 7, 8, 9, 10 and (the changes displayed in Columns 2 and 3 are included in Column 4). It also reflects the impact of the proposed FY 2008 update, and changes in hospitals' reclassification status in FY 2008 compared to FY 2007. The sum of these impacts may be different from the percentage changes shown here due to rounding and interactive effects.

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BILLING CODE 4120-01-P

BILLING CODE 4120-01-C

BILLING CODE 4120-01-P

BILLING CODE 4120-01-C

[FR Doc. 07-2806 Filed 6-1-07; 2:04 pm]

BILLING CODE 4120-01-P